Abstract
Orlistat is a gastrointestinal lipase inhibitor used for weight reduction in obese individuals. Enteric hyperoxaluria caused by orlistat leads to oxalate absorption. Acute oxalate nephropathy is a rare complication of treatment with orlistat. Herein we report a patient presenting with acute renal failure which improved minimal with intravenous hydration. She was found to have oxalate crystals on renal biopsy. Patient admitted orlistat use over the counter for weight reduction on further questioning. The purpose of this case review is to increase awareness among patients since they are more focused on losing weight. This case also calls for the provider attention to educate patients regarding side effects of orlistat because of easy availability of orlistat over the counter.
Highlights
Orlistat, a gastrointestinal lipase inhibitor, is used for weight reduction in obese patients with BMI > 30 kg/m2 and BMI > 28 kg/m2 with associated risk factors such as diabetes mellitus hypertension
We report a case of obese patient consuming orlistat for weight reduction presented with acute oxalate nephropathy manifesting as acute renal failure
Acute oxalate nephropathy is a form of kidney damage caused by oxalate crystal deposition in the renal tubular lumen
Summary
A gastrointestinal lipase inhibitor, is used for weight reduction in obese patients with BMI > 30 kg/m2 and BMI > 28 kg/m2 with associated risk factors such as diabetes mellitus hypertension. The rare but serious adverse effect of orlistat treatment is acute oxalate nephropathy caused by increased fat malabsorption. It is diagnosed by evidence of oxalate crystals in renal biopsy specimen under polarized light. We report a case of obese patient consuming orlistat for weight reduction presented with acute oxalate nephropathy manifesting as acute renal failure. The patient had anemia with a hemoglobin of 7.4 g/dL She denied having any previous medical problems but reported having intentionally lost 70 lbs over the last 18 months. She denied the use of any regular medications during her hospitalization and denied the use of nonsteroidal anti-inflammatory drugs (NSAIDs). During a later follow-up appointment, the patient admitted to the use of orlistat
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